OVERVIEW OF NATIONAL

BLOOD TRANSFUSION
SERVICE (NBTS)

BY
OKEREKE BENSON CHIMEZIE BLOOD,
NBTS/ CLUB 25/YEP FOCAL PERSON.
 Health Status
• Economic downturn in the mid-80s led to sharp
decline in social service _ health perhaps the worst
hit.
• Most of disease burden is due to preventable
diseases.
• Poverty is the major cause of these problems
• Maternal mortality rate is one of the highest in the
world(800-1,000/100,000 births).
• Under-5 mortality rate is higher than the average for
Sub Saharan Africa.
• Life expectancy is 52years.
 Health Institutions

• 60 Tertiary health institutions

• About 700 General and District Hospitals
• 15,000 private Health institutions
• Blood transfusion service in Nigeria was
fragmented, mainly hospital-based and with
little regulation before establishment of the
National Blood Transfusion Service
• The prevention efforts targeted at HIV/AIDS
was noted to be incomplete without
prevention of new infections from unsafe
blood
 The Nigerian situation
Where we hope to be
• Where we are • Nationally
• Fragmented coordinated blood
blood transfusion transfusion service
• Acceptance of the
services
concept of voluntary
blood donation as
• Use of paid
entrenched in the
donors and family National Blood Policy
replacement • Screening of
• Screening of transfused blood for
transfused blood four mandatory TTIs
with rapid test by WHO minimum
kits – mainly HIV standards
only • Well regulated and
• Poorly regulated coordinated system
and coordinated with proper
system documentation
• NBTS was established in Dec 2004 by the
Government of Nigeria in response to the
poor blood safety practices in the country
• A National Blood Policy was approved and
launched in the year 2006. This political will is
the backbone of the progress of the NBTS in
Nigeria
 Map Showing All NBTS Sites
(established & proposed for 2008)
Sokoto Kaduna Katsina
Nangere-Potiskum
Maiduguri
Jos

Abuja
Ado-Ekiti

Benin-City Lokoja
Ibadan
Jalingo

Abeokuta
Enugu

North West

Calabar North East

Lagos State
Blood Service Owerri North Central

Port-HarcourtSouth West
South South

South East
 The Progress So Far

• 17 established centers with 12 of these centers fully

operational with support from PEPFAR
Also Lagos State Blood Service.
• Guidelines on Blood Transfusion Practice available and
disseminated.
• Guidelines on Appropriate Use of Blood and Blood
Products reviewed, awaiting final approval before
printing and dissemination.
• Comprehensive baseline data on blood transfusion
conducted in March 2007.
• Best practices instituted in all NBTS centres.
 Blood Collection
• Estimated total number of blood units needed by Nigeria is
1,125,600 (WHO AFRO estimate) – based on12 beds per
10,000 populations, usage of 6.7 units of blood per bed
multiple and a population of 140,000,000. The blood needs
estimate represents 0.8% of Nigeria population.
• A total of 16,987 units of blood was collected in all the NBTS
operational centres over the period 1st January, 2007 to 31st
December, 2007.
• A total of 62,381 units of blood was collected over the same
period above by NBTS and 53 pilot hospitals linking with the
NBTS.
 Blood Collection by NBTS Centres (1st Jan, 2007 - 31st Dec, 2007)
NBTS BLOOD COLLECTION 2007    
                           
MONTH    
CENTRE JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL
ABUJA (Commenced
Dec. 2004) 104 89 169 139 167 107 251 130 266 412 276 332 2,442
KADUNA
(Commenced Aug.
2005) 137 236 392 55 120 121 283 244 210 269 456 244 2,767
OWERRI (Comenced
Nov. 2005) 109 297 267 23 151 236 260 254 178 195 228 201 2,399
IBADAN (C0mmenced
Jul. 2006) 221 202 178 19 139 146 114 205 230 149 360 339 2,302
LOKOJA
(Commenced Mar.
2007)     11 96 127 159 236 202 295 315 426 206 2,073
JOS (Cmmenced Mar.
2007     12 31 232 207 291 242 429 377 259 240 2,320
MAIDUGURI
(Commenced May
2007)         17 147 110 114 69 219 255 117 1,048
Benin (commenced
Sept 2007)                 157 362 403 627 1,549
Port-Harcourt
(commenced Aug/Sept
2007)               3 2 8 61 13 87
TOTAL 571 824 1,029 363 953 1,123 1,545 1,394 1,836 2,306 2,724 2,319 16,987
 NBTS/Hospitals Linkage Programme

The NBTS/Hospital Linkage programme is a collaboration

between the NBTS, Lagos State Blood Transfusion Service and
hospitals.
The goal of the programme is to ensure availability of safe blood
in hospitals.
The objectives of the programme:
• To encourage hospitals to send blood samples obtained from
family replacement and voluntary donors to NBTS for
centralised screening for the mandatory 4 transfusion
transmissible infections (HIV 1&2, Hepatitis B, Hepatitis C and
Syphilis) by machine-readable ELISA method.
• To encourage the establishment of hospital transfusion
committees where these do not already exist.
• To ensure that adequate amount of safe blood is available in
hospitals.
 NBTS/Hospitals Linkage Programme - 2
• As a result of advocacy
towards the realisation of
the above objectives, a total
of 2,816 units of blood
collected by hospitals have
been submitted to the NBTS
for screening as at 31st
March, 2008.
• Fifteen(15) hospitals have
either inaugurated or
resuscitated their hospital
transfusion committees.
Geopolitical Zone Hospitals with Hospital
Transfusion Committees
South-South •University of Benin Teaching
Hospital, Benin-City
•Delta State University Teaching
Hospital, Warri
South-West •University College Hospital,
Ibadan
•Lagos University Teaching
Hospital, Lagos
•Federal Medical Centre,
Abeokuta
South-East •Imo State University Teaching
Hospital, Orlu.
•Federal Medical Centre, Owerri
•Living word mission Hospital-
Aba
•General Hospital- Awka
•St Charles Borroweo Hospital-
Onitsha
North-Central •Jos University Teaching
Hospital, Jos
•Federal Medical Centre,
Makurdi
•Federal Medical Centre, Lokoja
•Federal Medical Centre, Bida
North-East •University of Maiduguri
Teaching Hospital, Maiduguri
•State Specialist Hospital,
Maiduguri
•Federal Medical Centre, Nguru
North-West Barau Dikko Specialist Hospital
 TTIs Prevalence Among Blood Donors
and in the General Population
TTIs National NBTS NBTS
Prevalence Prevalence Prevalence
Rates (%) Rates Rates
Among Among
Donors (%) Donors (%) TTIs prevalence rates among blood donors
(2006) (2007)
and in the general population

HIV (2005) 4.4 3.0 (1st 2.5 14.0%

Time
donors) 12.0%
0.1
(Regular 10.0%
donors)
8.0%

ates(%)
6.0%
Hepatitis B 12.0 9.7 10.9

revalenceR
4.0%
2.0%
Hepatitis C 3.0 3.0 2.5
TTIsP 0.0%
HIV Hepatitis B Hepatitis Syphilis
Syphilis <1 0.8 0.3 C

National Prevalence Rates (%) NBTS Prevalence Rates Among Donors (%)
 Age & Sex Distribution of Blood Donors (Jan-Mar 2008)
% Age Distribution of Blood Donors
Sex Distribution of Donors

56-65yrs (2.10%)

46-55yrs ( 5.20%)
Female
36-45yrs (12.20%)
Donors
18-25 yrs (46.60%)
20%

male
26-35yrs (33.90%) Donors
80%
 Walk-in Donors and Mobile Blood Drive Donors, NBTS Kaduna
First Time & Repeat Donors, NBTS Kaduna

Walk-in Blood Donors,

Repeat Donors, 17.70% 16.90%

1st Time Donors, 82.30% Mobile Drive

BloodDonors, 83.10%
 Clinical Needs for Blood
-Utilisation pattern
• Nutritional and malaria induced anaemias
• Road Traffic Accidents
• Surgical interventions
• Gynaecological procedures
• Internal Medicine
 Blood Use
• 80% as whole blood
• 15% as packed cells
• 5% as components
• Points to non-optimal use of blood and
components
• Components produced in a few Centres –
mainly Teaching Hospitals
• Not due to lack of knowledge but lack of
Equipment
 Strengths and Weakness
• Now, strong political will to organise a centralised
system.
• Health System Reforms in progress.
• Big country- 130 million people.
• Some of the most endowed persons in Sub Saharan
Africa.
• Centralised system expensive to establish.
• Country is large(900,000sq km).
• Poor, neglected infrastructures.
 Success Stories
• A centralised NBTS now in operation after 4 decades.
• A revised National Blood Policy, Operational guidelines and
Baseline Data survey disseminated now.
• Operational centres in Abuja, Kaduna and Owerri
• Ibadan, Port-Harcourt, Jos, Maiduguri, Abeokuta to follow
this year.
• Developed crop of young-volunteer, non-remunerated blood
donors.
• Donor Clubs being organised Nationwide.
• Developed awareness of healthy lifestyle among donors.
• Organised local training for all categories of staff including
policy makers.
• Developed concept of safe and best laboratory practices
 Challenges
• Shortage of skilled professionals particularly in donor
care management.
• Overcome fears, myths, attitude and apathy of
Nigerians about blood donation.
• Poor communication network and linkages.
• Issues of regular supplies of laboratory equipment
and consumables.
• Orientation of work attitudes in a service like the
NBTS.
 Challenges cont.
• Promotion of VNRD nationwide.
• Conversion of FRD to VNRD.
• Establishment of Hospital Transfusion Committees in
more hospitals.
• Reduction of blood screened by rapid tests in
hospitals.
• Need for centralised screening or centrally
coordinated screening through NBTS approved
centres.
• Logistic challenges- poor road network, power supply
(being addressed using solar power)
 WAY FORWARD
• Stronger advocacy and sensitisation of policymakers at all
levels ‘to buy’ into the programme
• Increased donor awareness campaigns. There is a need to
conduct a KAP study so as to specifically address identified
concerns on voluntary donation of blood
• Increased collaboration with hospitals to establish and
strengthen NBTS linkage with hospitals
• Advocacy for hospital transfusion committees to standardize
clinical use of blood and blood products.
 Future Plans

• States persuaded on legislation to ban commercial blood

donors & banks
• Public Private participation with telecommunication
companies to enhance follow up of VNRD and encourage new
donors
• Mount aggressive campaigns for development of donor
clubs Nationwide
• Continuing staff training and capacity building
• Improve on performance of the Zonal Centres
 Opportunities
• Strong political will.

• Increasing number of NBTS Centres.

• Large pool of human resource.

• Large pool of potential donors.

• Support from donor agencies and developmental

partners.
.
 Threats
• Political instability.
• Frequent posting of trained staff.
• Reluctance to voluntary blood donation due to cultural and
religious taboos, myths etc.
• Poor basic infrastructure making it expensive to run NBTS centres
• Uncooperative attitude of health workers and blood service
outlets to change to a centrally coordinated system.
 CONCLUSION
• NBTS is on track and has the human capacity
to succeed.
We are sufficiently
encouraged by the
Nigerian spirit
which when it
ignites, fires on
and on and on and
on………
Thank you for your attention!